Understanding the signs of ADHD in teens is important for educators, parents, and professionals, as an early diagnosis can set youth up for success. ADHD symptoms in teens often mirror symptoms of depression or anxiety including disorganization; change of appetite; bursts between low and high energy; and even withdrawal from activities.
What is ADHD?
Attention-Deficit Hyperactivity Disorder, commonly noted as ADHD, is a diagnosis characterized by patterns of inattention, hyperactivity, and/or impulsivity that are ongoing, and interfere with daily functioning and development.(FN1) Often, there is a higher rate of an ADHD diagnosis in males than in females. Symptoms of ADHD begin forming in children as early as age seven or eight.
The three presentations of ADHD include:
- Inattentive: Inattentive ADHD can be seen in individuals who have poor concentration. These individuals are usually easily distracted, have difficulty staying on task, and struggle to remain organized.
- Hyperactive/Impulsive: An individual that fits in this type of ADHD is shown to have characteristics that display inability to “turn off.” This might mean that they talk excessively; fidget in their seat or with their hands; or appear restless, even in situations where remaining relaxed is expected.
- Combined: Have you ever noticed someone that appears to be withdrawn at certain times, and then constantly on the go and ready to take action later on? This person fits into both categories of ADHD, and therefore experiences the combined type.
ADHD Symptoms in Teens
While every individual is unique, it is very common to see similar symptoms of ADHD in teens. And, these same symptoms may also be experienced by neurotypical teenagers as well! Teens often become withdrawn, isolated, easily distractible, and may even exhibit signs of general disinterest. Sounds a bit like puberty, doesn’t it? The difference is that ADHD symptoms have occurred over an extended period of time and meet criteria that typical puberty does not. ADHD symptoms in teens are marked by a larger impact on relationships, school, and home life. Signs of ADHD in teens may also be seen through ADHD paralysis and ADHD masking.
Common ADHD symptoms in teens include: 2
- Chronic procrastination: This is continued delay of tasks regardless of deadline, while also prioritizing lesser important responsibilities.
- Impulsivity: An act without thought of consequences, often by taking immediate action for temporary satisfaction.
- Maladaptive daydreaming: Frequent preoccupied thoughts for a flight of ideas that are not related to current real life needs, tasks, or scenarios.
- Rejection sensitive dysphoria: An individual who may be emotionally sensitive to feedback provided, especially if negative.
- Anhedonia: This is the lack of pleasure or joy in situations that would have otherwise been exciting.
- Psychomotor agitation: An individual experiencing this will have a change in their gait and dexterity.
- Time management problems: Seen often within not knowing how to prioritize various tasks or social events.
- Appearing not to listen: A teen may appear disengaged in conversation, even when being directly spoken to.
ADHD Symptoms in Teen Girls vs. Boys
With the understanding that puberty impacts girls and boys differently, it’s important to note that some signs of puberty might also be characteristics of ADHD. Furthermore, puberty and ADHD do not look the same in girls and boys. Girls with ADHD may begin to show signs of increased withdrawal and decreased activity, while more impulsive behaviors are seen in boys. ADHD becomes more difficult to detect in girls, because retreating and withdrawal may sometimes be correlated to one’s menstrual cycle and the start of puberty. Thus, boys are diagnosed at a much greater rate.3
How Does ADHD Affect Teens in Daily Life?
Teens often struggle with their ADHD, as they might not recognize the warning signs and symptoms in order to get the help they need. They may face challenges when it comes to activities of daily living such as maintaining healthy hygiene routines, nutrition, and relationships. Additionally, teens commonly exhibit mood changes, which may impact peer relationships and potentially their academics. These factors are directly related to puberty, making it tough to discern if a teen is going through typical hormonal changes, or in need of further care; this can make it more unlikely to recognize underlying signs and symptoms associated with ADHD and potentially delaying a formal diagnosis.
Complications of ADHD symptoms in teens may include:
- Substance use
- Increased risk of car accidents
- Suicidal ideation
- Missing assignment deadlines
- Withdrawal from friend groups and decrease in social support
- Change in appetite contributing to weight gain or weight loss
- Deficits in school grades
- Feelings of failure
Teens With ADHD & Relationships
While teens navigate the everyday challenges of puberty, the addition of ADHD symptoms can provide even more challenges within a teen’s everyday relationships with others. They may not be understood by their peers when they are experiencing periods of social withdrawal, irritability, or mood changes. If a youth has a strong and supportive group of friends, they may choose to discuss the feelings and emotions associated with their ADHD diagnosis, and guide their friends on ways to offer support. To maintain healthy relationships, a teenager might establish a plan for engaging with close friends when they begin to experience signs of social withdrawal.
How Is ADHD in Teens Diagnosed?
As ADHD is usually diagnosed in childhood, certain symptoms in teens may be misdiagnosed or attributed to other mental health conditions including depression or anxiety. It is important to keep in mind that, despite misdiagnoses, these symptoms are still attributed to a person’s ADHD. Teens can reach out to a healthcare provider to complete a diagnostic assessment and achieve an accurate diagnosis.
The current criteria for diagnosing ADHD in teens includes:
- Symptoms must be present for at least six months
- Signs and symptoms are not developmentally appropriate for a person’s age
- Symptoms that are present must occur in two or more settings
- Symptoms impact daily functioning
- Other mental health disorders with similar symptoms have been ruled out
- Some symptoms were present before age 12
For teens under the age of 16, criteria includes:
- At least six symptoms of inattention
- At least six symptoms of hyperactivity-impulsivity
For teens over the age of 17, criteria includes:
- At least five symptoms of inattention
- At least five symptoms of hyperactivity-impulsivity
Treatment for ADHD in Teens
When working with an ADHD diagnosis, remember that “one size does not fit all.” Comprehensive treatment of a teen with ADHD will generally include both medication and talk therapy, with providers working together to strive for the best outcome for a teen and their family. It is often best to first explore what type of ADHD a teen has by understanding their behaviors, and finding appropriate medication to treat these symptoms.
The use of ADHD Medication for teens is crucial, as it allows the brain to trigger signals that connect the pieces of the brain that might not be coordinating properly. Stimulants work by releasing dopamine, allowing teens the opportunity to remain alert, focused, and engaged. Non-stimulant medications target brain chemicals often associated with depression, and are often prescribed if stimulants have not improved symptoms.
Common medications for symptoms of ADHD in teens include:
- Adderall (amphetamine)
- Vyvanse (lisdexamfetamine)
- Strattera (atomoxetine)
- Evekeo (amphetamine)
- Ritalin (methylphenidate hydrochloride)
Therapy is a very useful tool, in that it gives a teen the space and opportunity to understand their ADHD diagnosis. Therapy aims to address impulsivity, overwhelm, and feelings of depletion–commonly seen through symptoms of anxiety and depression. Working with a therapist can allow a teen to identify various patterns of behavior, and take steps to improve day to day engagement.
Therapy options for ADHD symptoms in teens include:
- Cognitive behavioral therapy (CBT): CBT for ADHD in teens is extremely helpful, as it allows a teen to identify the connection between their thoughts and actions.
- Dialectical behavioral therapy (DBT): When treating through DBT, teens are able to learn about how their environment and biological factors impact them.
- Motivational Interviewing (MI): MI provides a supportive environment for teens to express their feelings and thoughts in their own words.4
- Behavior Training: 5 Behavior training engages parents and family, showing the ways that they can provide support for their teen.
10 Ways to Cope With ADHD Symptoms as a Teen
While it may seem difficult to navigate ADHD, there are some daily lifestyle changes that teens can make to cope with their symptoms. It is important that teens feel empowered to make and establish autonomy over themselves and what this new diagnosis may mean for them. This includes adopting healthy sleeping, eating, and other routines that will be beneficial for the teen and their relationships.
Here are 10 ways to cope with ADHD symptoms as a teen:
- Limit screen time: This is a helpful tool for teens, so that there are less distractions for them to focus on.
- Get involved in activities: Keeping active releases endorphins and allows teens with hyperactive ADHD to experience a decrease in anxiety.
- Maintain healthy sleep routines: A good wind down routine leads to a good night’s sleep, and helps promote feelings of being well-rested and more engaged the next morning.
- Establish healthy eating patterns: Eliminating sugars and fatty foods helps improve energy levels.6
- Create simple daily routines: Simple daily routines include having items like toothbrushes, vitamins, or wash cloths in plain sight, so that daily activities are followed through without setting reminders.
- Identify a peaceful space: This is a great way for teens to reset when needed in moments of overwhelm; make sure that there are no family members or friends occupying the space at the same time.
- Brain dump when overwhelmed: Getting one’s thoughts out on paper allows a teen to map out a priority list and feel more in control of their anxious feelings.
- Spend time outdoors: Natural sunlight and Vitamin D releases chemicals in our minds, helping us to feel more focused.
- Explore hobbies: Finding a hobby and outlet for creativity gives teens the opportunity to have autonomy over their day to day when they otherwise might feel overwhelmed.
- Ask for help: Seeking support will help a teen stay focused and on task for what they need, rather than fall short or behind and perpetuate a feeling of continued failure.
How to Help a Teen With ADHD
Offering support to a teen navigating an ADHD diagnosis can be the most important part of their treatment. A healthy environment can be created by remaining open, empathetic, and encouraging in moments when a teen might feel alone. You can provide support by asking your teen what they need help with each day. Keep in mind that this might look different day-to-day, and being flexible to these changes keeps the teen feeling safe.
You can support a teen with ADHD by:
- Setting clear and healthy boundaries regarding expectations (deadlines, social events, grades in school)
- Rewarding positive behaviors
- Providing support by asking what they need from you
- Remaining open to hearing their struggles within an inviting space
- Being flexible when their needs change and vary over time (what worked at first might not work forever)
- Making time to talk about and discuss things that went well for the week and things they want to improve on
While the symptoms of ADHD can be difficult to deal with and feel isolating as a teen, there are effective treatments available to not feel so alone. You can reach out to a local mental health professional if you or your teen might need therapy; you can start your search using an online therapist directory.